What does critical thinking mean to you in the courses you teach?

Knowledge

Skills

Ability

Confidence

Achievement

Thinking

Critical

To Develop

Course

Redesign of

Wayne LaMorteSchool of Public Health

The Problem

“Everyone thinks. It is our nature to do so. But much of our thinking, left to itself, is biased, distorted, partial, uninformed, or downright prejudiced. Yet, the quality of our life and that of what we produce, make, or build depends precisely on the quality of our thought. Shoddy thinking is costly, both in money and in quality of life. Excellence in thought, however, must be systematically cultivated.”

From CriticalThinking.org

What is critical thinking?

[Creation]Evaluation Synthesis Analysis

Application Comprehension

Knowledge

Bloom’s Hierarchy of Intellectual Behaviors in the Cognitive Domain

A Taxonomy of Significant Learning

A Critical Thinker:

•Raises vital questions and problems, formulating them clearly and precisely •Gathers and assesses relevant information, using abstract ideas to interpret it effectively •Comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards •Thinks open-mindedly within alternative systems of thought, recognizing and assessing, as needs be, their assumptions, implications, and practical consequences •Communicates effectively with others in figuring out solutions to complex problems

From CriticalThinking.org

Relevant Questions for Critical Thinkers: 

•What is the most fundamental issue here? •From what point of view should I approach this problem?•Does it make sense for me to assume this? •From these data may I infer this? •What is implied in this graph? •What is the fundamental concept here? •Is this consistent with that? •What makes this question complex? •How could I check the accuracy of these data? •If this is so, what else is implied? •Is this a credible source of information? •Are there alternative ways of thinking about this?

Adapted from CriticalThinking.orgThinking outside the box.

Lateral thinking.

For My Students: Foundational Skills & a Structured Approach to Problem Solving

Evaluate information in a structured way in order to identify valid causal associations.

Evaluate efficacy (programs, treatments, interventions).

Make accurate predictions, e.g., who is at high risk?

Weigh risks and benefits.

Cultivate a habit of thinking & reading critically. Distinguish validity from fallacy.

Make evidence-based decisions.

Critical Thinking Skills

Question

Define

Conceptualize

ExamineAnalyze

Infer

SynthesizeDon’t just accept; be inquisitive. Formulate testable questions.Develop clear definitions of

outcomes & possible determinants (causes) .What are the options for

testing the hypothesis? Feasibility? Advantages? Limitations?

Collect accurate data. Organize it to facilitate thinking and comparisons.

Test the hypothesis. How strong is the association? How precise is it? Evaluate the role of random error, bias, & confounding.Can one infer that findings in the study group apply to the source population?

Critically review the body of evidence. Are the criteria for making a judgment of causality met?

How do we promote critical thinking?

Definition of a Lecture: A talk on some subject to an audience or class. Also: A long or tiresome scolding.

“I recall once saying that when I had given the same lecture several times I couldn't help feeling that they really ought to know it by now.” — J. E. Littlewood (1885-1977)

Bakst Auditorium, 2007Laurentius de Voltolina, late 1300s

I SAID I TAUGHT HIM. I DIDN’T SAY HE LEARNED IT

I DON’T HEAR HIM WHISTLING

I TAUGHT STRIPE HOW TO WHISTLE

Cartoon by Bud Blake

Teaching vs. Learning

Wk Pre-Class Class (Lectures) Post-Class

1 Reading Syllabus, History, & Descriptive Studies

2 Reading Overview of Analytic Studies PS 1 – Study Designs

3 Reading Dis. Freq. PS 2 – Dis. Freq.

4 Reading Association PS 3 - Association

5 Reading Random Error PS 4 – Random Error

6 Reading Clinical Trials TAKE-HOME EXAM

7 Reading Cohort Studies PS 5 – Cohort

8 Reading Case-Control Studies PS 6 – Case-Control

9 REVIEW MIDTERM (in-class)

10 Reading Bias PS 7 - Bias

11 Reading Standardization & Adjusted Rates PS 8 – Adjusted Rates

12 Reading Confounding & Effect Modification PS 9 - Confounding

13 Reading Screening PS 10 - Screening

14 Reading Causal Inference REVIEW

15 REVIEW FINAL EXAM (in-class) 10 problem sets;

Lecture

Homework (Active Learning)

Assigned Reading

Exam

Assigned Reading

Certainly we need:

•Engagement•Active Learning•Progressive Challenges•Feedback•Fewer bulleted slides (…oops)

Kolb's Experiential Learning Model

Concrete Experience

Abstract Conceptualization

Act

ive

Exp

erim

enta

tion

Reflective

Observation

…which can be 'actively tested,' in turn creating new experiences.

‘Concrete experiences' provide a basis for 'observations and reflections'.

These 'observations and reflections' are assimilated…

… and distilled into 'abstract concepts' producing new implications for action…

Concrete Experience

Abstract Conceptualization

Act

ive

Exp

erim

enta

tion

Reflective

Observation

Passive

Direct experience

Recall experience

Class exper. (lab)

Lecture e.g.

Lecture

Critique

Paper

Model building

Rh

eto

rical ?

Discu

ssion

Bra

insto

rm

Journ

alF

ield

wo

rk, l

ab

Ho

me

wo

rk, p

roje

ct

Ca

se S

tud

ies

Lec

ture

e.g

.

Progressive Refinements to the Course

Examples were updated, emphasizing current problems in public health.

Lectures broken up with:• Problem sets• Clicker questions• Discussion

Homework was automated to provide immediate detailed feedback on problems.

Analysis and interpretation of raw data was added.

Independent Analysis of a Large Dataset

Video

Data Set With > 3,000 Subjects

“EpiTools”: an Excel file with a series of statistical tools

An invitation to explore: what if….?

All 120 students successful mastered the raw data analyses.

Course evaluations:

• 98% of students strongly agreed (78%) or agreed (20%) that “I acquired new information (facts and concepts I understand) in this course.”

• 93% of students strongly agreed (78%) or agreed (15%) that “I acquired new skills (things I can do) in this course.”

• Overall, 89% of respondents said the degree of difficulty of the course was “about right,” 6% said it was “too hard,” and 2% said it was “too easy.”

Students now report that they use these skills for other courses and projects and in their part time jobs.

Results

The Next Phase (still in progress)

A Self-Directed Guide toDesigning Courses for Significant Learning

L. Dee Fink, PhDDirector, Instructional Development Program

University of Oklahoma

Author of:Creating Significant Learning Experiences:

An Integrated Approach to Designing College Courses

LearningGoals

Feedback &Assessment

Teaching & LearningActivities

Key Components of Integrated Course Design

Situational Factors

ActiveLearning

SignificantLearning

EducativeAssessment

From L. Dee Fink (120 students; beginners;

breakout rooms for only one class)

Example of a Course that is Not Integrated

‘The teacher says the learning goals are to (a) “learn all the important content” and (b) “learn how to think critically about the subject.”

But, it is a straight lecture course (this is the “teaching/learning activity”), so the teaching/learning activities are NOT aligned with the learning goals. Students might be able to learn the content from the lectures, but they definitely arenot getting practice and feedback in learning how to think critically.’

From L. Dee Fink

From L. Dee Fink

Surveillance; Frequency;Hypotheses; Strategies

1 2out out out

Measuring Association;Random Error

3 4out out out

RCT; Cohort; Case-Control5 6

out out out

Bias, Confounding7 8

out out out

Screening for Disease9 10

out out out

Critical Reading; Causal Inference

11 12out out out

Open Discussion of ProblemQ&A

Mini-LectureIndividual & Team Exercises

Progressive Disclosure Exercises

Reading, Videos, Skill Building, Problems, Pre-Class Quizzes (interactive web pages + progressive problems; challenging

problem [post your discussion online before class])

Reading, Videos, Skill Building, Problem Sets (interactive web pages + progressive problems; challenging

problem [post your discussion online before class])

Wk Pre-Class Class Post-Class

Surveillance;Frequency;Hypotheses;Strategy

1 Syllabus, History . & Descr. modules;; Flu Shot Ex.; Forum ; Pre-Quiz

Flu Shot DISCUSSION Descriptive. Epi lect. – Loop back

2 Analytic module; Pre-Quiz Analytic Overview lect. - Clickers PS 1 – Study Designs

3 Surveillance & Dis. Freq. modPre-Quiz

Dis. Freq. lect. - Clickers PS 2 – Dis. Freq.

Ass’n; Random Error

4 Association mod. - Pre-Quiz Association lect. – Clickers + EX PS 3 - Association

5 Random Error mod. - Pre-QuizVideo on EpiTools

Random Error; EX PS 4 – Random Error

RCT;Cohort; Case-Control

6 Res. Ethics mod. + ForumRCT module - Pre-Quiz

DISCUSS; Q&A; Progressive ASA; Karachi; EX: Risk/ Benefit

TAKE-HOME w/ RCT

7 Cohort Study mod. - Pre-Quiz Review Cohort; Progressive Disclosure; GUEST LECT.; BWHS:

PS 5 – Cohort + HDL Analysis/Interpretation

8 Case-Control mod. - Pre-Quiz Case-Control Lecture; GUEST LECT. SSRI & Birth Defects

PS 6 – Case-Control + Analysis/Interpretation

9 REVIEW MIDTERM (in-class)

Bias; Confound

10 Bias module - Pre-Quiz Lecture + DISCUSSION PS 7 - Bias

11 Adjusted Rates; Confounding / Effect Modification - Pre-Quiz

Adjusted Rate lect. + EX PS 8 – Adjusted Rates

12 Confounding II; Effect Modification - Pre-Quiz

Lecture +Progressive Disclosure

PS 9 - Confounding

Screening; 13 Screening module - Pre-Quiz Lecture + Guest Lecture: Mammography Controversy

PS 10 - Screening

Critical Read;

Causation 14 Critical Reading; Causality mod.

Critical Analysis: OSHA testimonyBREAKOUT - ETS papersDISCUSSION; OSHA testimony;

REVIEW

15 REVIEW FINAL EXAM (in-class)

Inference & Causality Link to Module 1

A Progression from Fundamentals Skills to Increasingly Complex Problem Solving

A prospective cohort study was used to compare lung cancer mortality in smokers and non-smokers.

Among 20,000 non smokers there were 20 deaths from lung cancer during 5 years of study. Among 5,000 smokers there were 100 deaths from lung cancer during the 5 year study period.

1) Organize this information in a 2x2 contingency table.2) Calculate the cumulative incidence of death (per 1,000) due to

lung cancer in smokers and non-smokers.3) Calculate the relative risk; interpret it in words.4) Calculate the risk difference; interpret it in words.5) Calculate the attributable proportion in the exposed subjects;

interpret it in words.6) Calculate the population attributable fraction; interpret it in words.

An In-Class Exercise (Class #4)

Risk vs. Benefit –Aspirin to Prevent Heart Attacks

Crestor to Prevent CVD Events In people with normal LDL but elevated CRP

Crestor vs. Moderate Exercise to Prevent CVD Events

(Class #6)

(Class #7)

(Class #7)

Progressive Disclosure Exercises in Class

Link to Manson et al.: Cohort Study

Link to Karachi Hand Washing RCT

(Class #7)

(Class #6)

One Hour Workshop Followed by Full Class Discussion(Class #14)

Are policies aimed at reducing exposure to environmental tobacco smoke (secondhand exposure) evidence-based?

Or are they the result of anti-tobacco zealots?

Link to Assignment

Link to class resources

Interactive learning modules and videos of abridged lectures can be accessed by smart phone as well.